Provider Demographics
NPI:1386498269
Name:BROOKS, JAZMIN DA'SEAN (RN)
Entity type:Individual
Prefix:
First Name:JAZMIN
Middle Name:DA'SEAN
Last Name:BROOKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6344 GATEWAY BLVD S
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-5446
Mailing Address - Country:US
Mailing Address - Phone:440-452-2898
Mailing Address - Fax:
Practice Address - Street 1:6344 GATEWAY BLVD S
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5446
Practice Address - Country:US
Practice Address - Phone:440-452-2898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.524942163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse